CHERRY CREEK SCHOOL DISTRICT

STUDENT TRAVEL

FIELD TRIP PERMISSION FORM

Dear Parent/Guardian:

Please read the information below, sign and return the form to your student’s first period teacher.

Trip Date_ November 9, 2017 ______Time_11:45am – 1:15pm______

Destination___Middle School 11 Building Site______Cost: _None______

She/he will be transported by

__X___School bus ______Walking ______Commercial Carrier

______Parent/Guardian arranged transportation as it is not school arranged.

______Other (please specifiy)______

  1. I understand that the field trip may take place away from school property; may involve transportation by school bus, private vehicle, common carrier or other mode of transportation; and may involve activities beyond the scope of traditional school functions conducted on school district property.
  2. I understand that the student’s participation is voluntary, and that by participating in the field trip, such participation potentially involves risks and obligations that are impossible to predict but which are beyond the scope of those normally associated with traditional school functions conducted on school district property. These may include but are not limited to the risk of loss or damage to personal property, the risk of sickness, personal injury or death while participating in the field trip and the obligation for payment of fees and costs associated with the field trip.
  3. I exempt the Cherry Creek School District, its employees and authorized volunteers from all claims arising from the student’s participation in the field trip unless caused by actions for which the school district would otherwise be liable under Colorado law.
  4. I understand that the Cherry Creek School District does not purchase, or have any medical, dental or hospitalization insurance to cover injuries to or loss of life of pupils or to indemnify parents and guardians for expenses in connection therewith, and that such insurance, if desired, must be provided by the parent or guardian.
  5. I understand that my student must adhere to all regulations and policies of the Cherry Creek School District and Middle School 11.

If you have questions, please contact Connie Berrett at 720-886-6000 or by email at cberrett@cherrycreekschools.

I ______have read and understand the above information and give permission as follows:

My student ______

_____May participate in the above described field trip.

_____May not participate in the above described field trip.

Signed______Date______

Home Telephone______

Phone where parent/guardian may be reached during the time of this trip______